Can hantavirus lead to kidney failure in a 34-year-old?

Question

Hello doctor,

I am 34 years old and work as an agricultural field worker, and over the past three weeks, I have been extensively handling rodent-contaminated grain storage areas without any adequate protective equipment.

I am currently experiencing worsening symptoms such as fever that is of high magnitude to 40.2 degrees Celsius, a very intense headache, intense back pains, an increase in creatinine levels to dangerously high amounts of 3.2 mg/dl from my most recent level of 0.88 mg/dl, and reduced production of urine up to 350 ml in 24 hours.

I have a platelet count falling to a critically concerning 57000 per microliter that has still not prompted any consideration of hantavirus from my current treating doctors, who continue to manage me for acute pyelonephritis.

Is it possible for an attending general practitioner to make urgent inquiries regarding the possibility that the said patient, aged 34 years, who is working as an agriculturist, has been heavily exposed to rodents, has oliguria, and his creatinine, which is increasing fast with a value of 3.2, may be having hemorrhagic fever with renal syndrome due to hantavirus infection?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern and will definitely help you with it.

Your situation is very concerning, and you should seek urgent hospital-level care immediately, preferably in a center with infectious disease, nephrology, and critical care support.

A 34-year-old farm worker who has been exposed to many rodents has a high fever, intense headaches, back pain, oliguria, a rapid increase in serum creatinine, and thrombocytopenia must definitely be considered for hemorrhagic fever with renal syndrome due to hantavirus, particularly if there is environmental exposure to rodents.

While acute pyelonephritis can also cause fever and kidney injury, the combination of falling platelet count, reduced urine output, and rodent exposure makes hantavirus an important diagnosis that should not be missed.

This disease will rapidly advance into severe kidney injury, bleeding, shock state, and the need for dialysis. Early diagnostics will involve a test for hantavirus serology or polymerase chain reaction. The patient will be under observation concerning the condition of the kidneys, fluid-electrolyte balance, coagulation, and possible need for dialysis.

Intravenous Ribavirin has been used in some cases of Hemorrhagic fever with renal syndrome and may be considered early in severe disease depending on regional protocols and specialist judgment, but the decision about dosing and initiation should be made urgently by the treating infectious disease team because it is not appropriate to self-start treatment.

Please go to an emergency department or tertiary care hospital as soon as possible and clearly inform them about the extensive rodent exposure and the rapid worsening of your kidney function and platelet count.

Hope I have addressed all of your queries and concerns.

Do follow up whenever needed.

Thank you.